"Stressful maternity experiences"

With each appointment at Box Hill Hospital Maternity Service, I leave feeling less safe, more anxious and progressively more disempowered. I’m beginning to wonder whether choosing to have my first baby at Box Hill Hospital was a huge mistake.

As a previous hospital employee, and as a survivor of healthcare-related gynaecological trauma, I had believed that receiving maternity care through the Midwifery Group Program was the best plan for me. I referred myself to the program at 6 weeks gestation. At 20 weeks I called the program manager, as the midwives at my appointments had no information about the service. The MGP manager informed me that I hadn’t been registered in their system, but they placed me on the list. Now at 30 weeks, I still have not heard back.

The lack of continuity of care has been challenging. The midwife appointments to date have been rushed, with information delivered in an abrupt and often insensitive manner. Today’s midwife was the exception – greeted me with a kind smile, treated me with gentleness and respect, and actually read my patient history. The midwife gained consent before palpating my pubic bone (other midwives have not), and the abdominal examination was the only one that was not painful.

Due to growing concerns about my choices and Box Hill’s strict policies regarding due dates and induction, I had prepared a number of questions. The midwife answered a couple, then apologised: I’m sorry, we don’t have time to discuss these things today. When I asked about opportunities to ask questions and gather more information, the midwife replied: maybe at your birth classes? Maybe with the next midwife? I’m sorry, these appointments are just scheduled tightly so there isn’t really time for many questions.

Due to previous trauma, I am hoping for a birth that involves minimal medical intervention, ideally a water birth. I especially hope to avoid an episiotomy, forceps/vacuum and epidural. However, the consistent message is that (despite being a low-risk Green Pathway) I will not be allowed to carry past my due date. There is minimal choice with induction options – prostaglandin, rupture of membranes, syntocin (oxytocin) drip are all mandatory if this is the decision of the obstetrician. Once induced, I will not be allowed to leave the ward, or labour and birth in the bath as I will be under constant monitoring as the medications administered carry high risks of uterine hyperstimulation and foetal distress. My movement will be restricted due to the IV drip and monitoring, which will reduce my options for an active labour.

The midwives have informed me that first-time mothers pretty much always require an epidural post-induction due to the severity of the medically induced contractions – so I will labour and give birth on my back, significantly increasing my risk of pelvic floor trauma/ tearing, instrumental birth, maternal exhaustion, foetal distress and emergency caesarean.

It seems that the only way I can protect myself from further trauma is to (fingers crossed) go into spontaneous labour and then refuse all interventions. Induction seems to be a rigid one size fits all approach that completely disregards individual needs and preferences – the first step in a cascade of intervention that appears impossible to avoid.

Wouldn’t it be wonderful if care could be delivered by known clinicians, who work to empower the expectant mother and guide her to make choices that maximise her chances of achieving her desired birth outcome?

There is more to giving birth than, so long as you and the baby are both alive. Simply surviving is a very low bar to set.